Cracking the Code of Coronary Calcium: How New Innovations Are Revolutionizing Heart Care

Coronary artery calcification isn’t often top of mind when thinking about serious health issues. But this condition – where crystals of calcium deposits build up in the arteries – is quietly threatening the lives of millions of Americans, hardening arteries, blocking blood flow and weakening heart health. But new advancements, including a treatment called intravascular lithotripsy (IVL), are poised to transform how we manage – and potentially prevent – these often life-threatening conditions.

What is Coronary Artery Calcification?

Coronary artery calcification (CAC) occurs when chunks of calcium collect inside the heart’s two main arteries. CAC tends to affect older individuals more frequently, but lifestyle factors like smoking, poor diet and lack of exercise can accelerate the buildup. Over time, calcification can remodel once elastic arteries into hardened, brittle pipes, putting patients at risk of heart attacks, heart failure and even death.

Traditionally, physicians have only had procedures like balloon angioplasty, stenting or atherectomy – where a high-speed drill is used to grind away plaque within the artery – to treat CAC. However, these methods often struggle when faced with rock-hard calcium deposits and can pose serious risks, including damage to the soft arterial wall, suboptimal stenting and other complications.

“A lot of existing treatments weren’t designed with extensive calcification in mind,” says Dr. Kartik Giri, an interventional cardiologist at The Heart House in Cherry Hill, NJ. “We’re seeing older and sicker patients with greater frequency, and current therapies can’t always provide the outcomes we hope for. For example, an option like atherectomy can sometimes feel like trying to chip away at an iceberg with an icepick – it’s just an underpowered tool in some instances.”

The Promise of IVL

IVL has gained attention in recent years as a more precise, efficient, and effective treatment for tough arterial calcium. Borrowing from the field of kidney stone treatment, IVL uses low-frequency, high-pressure sound waves to “shatter” the calcified plaque within the artery without damaging the vessel walls.

“I compare IVL to dropping a stone in a pond, creating ripples of energy that break through hardened plaque,” says Dr. Venita Chandra, a vascular surgeon at Stanford Health Care in Palo Alto, CA. “With IVL, we’re able to precisely target and create tiny cracks in even the hardest calcified plaque into tiny fragments retained within the arterial walls, making the vessels more flexible and treatable with balloons or stents without risking the kind of trauma or less-than-ideal results associated with other methods.”

IVL is also particularly promising because of its ease of use and minimally invasive approach, which is ideal for older patients or those with a high risk of surgical complications. However, while groundbreaking, currently available, first-generation IVL technology still has its limitations.

FastWave: Advancing IVL for the Future

That brings us to one of the most exciting aspects of the IVL era: the fast pace of innovation. FastWave Medical is one of the companies whose innovations are designed to address some of the biggest challenges of current IVL devices.

Scott Nelson, co-founder and CEO of FastWave, explains the inspiration behind the company’s technologies, “Although current IVL offerings have demonstrated a clear clinical need, we saw an opportunity to solve for some of the obvious gaps based on consistent feedback from physicians across the world. By developing IVL catheters that are more deliverable, with greater precision and more energy availability, we hope to empower interventionalists with better options so more of their patients can benefit from this therapy.”

The team at FastWave is designing next-generation IVL systems with more durable yet lower profile balloons, larger and faster pressurized sound waves, the ability to treat longer blockages, and the capability to tackle even the hardest-to-cross blockages. These advancements could lead to higher success rates, even in patients with severe calcifications that resist current treatments.

Dr. Arthur Lee, an interventional cardiologist at The Cardiac & Vascular Institute in Gainesville, FL, believes FastWave’s approach could substantially improve IVL’s efficacy. “The main advantages here are deliverability, pulse count and balloon durability, meaning that with FastWave, we can access blockages that we can’t currently reach, we can treat longer and more diffuse calcium, and we can do it all in a potentially more efficient manner,” he shares.

As coronary artery calcification continues to be a significant health challenge in the United States, new technologies like IVL offer hope for patients and their physicians. And with companies like FastWave at the forefront, the future of heart health looks brighter than ever.

-Dr. Art Lee, FastWave Medical